0164T prior authorization | Anthem Blue Cross Blue Shield of Colorado

0164T, Removal of total disc arthroplasty, (artificial disc), anterior approach, each additional interspace, lumbar (List separ, is on the Anthem Blue Cross Blue Shield of Colorado prior authorization list. Not a coverage or referral decision.

Code: 0164T
Description: Removal of total disc arthroplasty, (artificial disc), anterior approach, each additional interspace, lumbar (List separ
Source: Colorado Prior Authorization List, Pg 121 Original policy

Anthem Blue Cross Blue Shield of Colorado prior authorization

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